Individual
KODY ALAN HINDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
670 PIERCE BLVD, O FALLON, IL 62269-2579
(618) 206-2094
(618) 607-5127
Mailing address
670 PIERCE BLVD, O FALLON, IL 62269-2579
(618) 206-2094
(618) 607-5127
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007288
IL
Other
Enumeration date
10/18/2019
Last updated
01/20/2022
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